Hernias, or ruptures, are common types of injuries, frequently caused by people attempting to lift heavy objects or otherwise straining their abdominal muscles. A hernia is a defect in the abdominal wall through which a portion of the intra-abdominal contents can protrude. This often causes discomfort and an unsightly, visible bulge in the abdomen. When such a hernia defect occurs in the abdominal region, conventional corrective surgery has required opening the abdominal cavity by surgical incision through the major abdominal muscles. While this technique provides for effective corrective surgery of the hernia defect, it has the disadvantage of requiring a hospital stay of as much as a week, during which pain is frequently intense, and it requires an extended period of recuperation. After the conventional surgery patients frequently cannot return to a full range of activity and work schedule for a month or more. Accordingly, medical science has sought alternative techniques that are less traumatic to the patient and provide for more rapid recovery.
Laparoscopy is the science of introducing a viewing instrument through a port into a patient's body, typically the abdominal cavity, to view its contents. This technique has been used for diagnostic purposes for more than 75 years. However, operative laparoscopy, in which surgical tools are inserted through a port for internal surgery is a comparatively new technique that has been in use for a decade or so. Operative laparoscopy is performed through tiny openings in the abdominal wall called ports. In most surgical techniques several ports, frequently three to six, are used. Through one port is inserted the viewing device, which conventionally comprises a fiber optic rod or bundle having a video camera affixed to the outer end to receive and display images from inside the body. The various surgical instruments are inserted through other ports to do the surgery that normally would be performed through an open incision through the abdominal wall. In laparoscopic procedures additional room for operation is generally provided by insufflation of the patient's abdomen by an inert gas, typically carbon dioxide. By the use of the laparoscope, various gynecological procedures have been performed and, more recently, gall bladder removal has been achieved through instruments inserted through additional trochars into the body. Because the laparoscopic surgical techniques require only very small holes through the abdominal wall or other portions of the body, a patient undergoing such surgery may frequently leave the hospital within one day after the surgery and resume a full range of normal activities within a few days thereafter.
Some efforts previously have been made to incorporate laparoscopic techniques into hernia repair surgery. These efforts have generally involved reducing the hernia by retracting the intra-abdominal contents away from the hernia defect and then stuffing a bundle of Mercelene surgical mesh or other suitable material into the defect to block the defect. In practicing this technique of "plugging the hole," a surgical grasper places a Mercelene patch over the plug or bundle or mesh, and that patch is clipped or stapled into place. This technique has been utilized with some success but has suffered from the requirement of stuffing a bundle of mesh into the defect and also from having no capability of spreading a patch of surgical mesh in a satisfactory manner to hold it in place smoothly and relatively rigidly during the fastening procedure. These deficiencies of this technique have caused difficulties, particularly from the inability to hold and affix such a patch in a smoothly expanded manner without causing substantial subsequent tension on the abdominal portions to which the mesh is affixed.